Arthroscopic treatment of septic arthritis of the metacarpophalangeal joint: Case report and technical description.

BACKGROUND

Cat bites to the hand are associated with a high risk of infection due to deep bacterial inoculation into closed anatomical spaces, frequently leading to severe complications such as septic arthritis. Although open arthrotomy has traditionally been the standard surgical treatment, arthroscopic management has become accepted in larger joints but remains rarely reported for metacarpophalangeal (MCP) joint infections.

OBJECTIVE

To describe the arthroscopic technique for the treatment of septic arthritis of the metacarpophalangeal joint and to report the clinical outcome of a patient with MCP septic arthritis following a cat bite.

METHODS

A 36-year-old woman developed septic arthritis of the index finger MCP joint following a cat bite. After failure of conservative treatment and empirical intravenous antibiotic therapy, arthroscopic irrigation and debridement of the joint were performed using a 1.9-mm arthroscope through two dorsal portals. Intraoperative findings, postoperative course, and functional outcome at 12 months were evaluated.

RESULTS

Arthroscopy allowed complete visualization of the joint and effective synovectomy, debridement, and irrigation. No purulent discharge was observed intraoperatively, but extensive chondral damage of the metacarpal head was identified. The infection resolved without recurrence. At final follow-up, the patient was pain-free and showed no clinical signs of infection, although residual limitation of MCP joint flexion persisted.

CONCLUSION

Arthroscopic management of septic arthritis of the metacarpophalangeal joint appears to be a feasible and effective minimally invasive alternative to open surgery in selected cases, allowing infection control with minimal soft tissue trauma. This technique may represent a valuable option in selected cases of acute MCP joint infections.